• Aye Thi Khaing
  • Sirinya Phulkerd
  • Amara Soonthorndhada
  • Ayesandar Mon
  • Pojjana Hunchangsith


Introduction: Complications during pregnancy and childbirth are the leading cause of death among women of reproductive age in Myanmar. It is generally believed by women in developing countries that pregnancy is a natural phenomenon and a part of women's reproductive functions. Problems or complications during pregnancy are also considered by such women as being natural to pregnancy. Low coverage of institutional deliveries, giving deliveries at homes without skilled provider and delays to reach to the health facilities are leading towards the vast majority of maternal deaths in Myanmar. Methods: The purpose of this study is to identify percentage of skilled birth attendant’s utilization among ever-married women (15-49 years) in Hlaing-Tharyar Township, Yangon, Myanmar. A quantitative cross-sectional survey was conducted. A total of 300 ever-married women who had delivered at least one child were selected by simple random sampling and face to face interviews were performed to them by using a pre-tested structured questionnaire. The structured questionnaire including socio-demographic background, history of last pregnancy, accessibility of health services, women’s autonomy and male involvement during pregnancy.

Results: The study found that 65 percent of the sample used skilled birth attendants (SBAs) at delivery and the association between mother’s education, place of residence, parity, number of antenatal care visits, women’s autonomy and male involvement were significantly related with using skilled birth attendant at delivery and postnatal health check. About one-third (35%) were received care from non- SBAs during delivery and the postpartum period in that township. Accessibility to health services and availability of health care personnel were not significantly associated with the use of skilled birth attendants in the delivery and postpartum of the last child.

Conclusions: Findings from this study highlighted that the majority of SBAs were providing reproductive healthcare services with a certain level of quality within the limited resource setting at the study area. There was a need to increase health education activities by SBAs for the pregnant and lactating mothers especially for utilization of maternal health care services. Awareness raising activities on the contraceptive method used should also be enhanced for all lactating women.


Ministry of Health Myanmar. Health in Myanmar 2014. Nay Pyi Taw; Myanmar; 2015.

Ministry of Immigration and Population. The 2014 Myanmar Population and Housing Census. Nay Pyi Taw; Myanmar; 2015.

UNFPA. Maternal and Neonatal Health in East and South‐East Asia. 2006.

Ministry of Health and Sports Myanmar. Maternal Death Review (MDR) Report Myanmar 2015. Nay Pyi Taw, Myanmar; 2017.

World Health Organization. WHO technical consultation on postpartum and postnatal care. Geneva: World Health Organization; 2010.

World Health Organization. Global reference list of 100 core health indicators (plus health-related SDGs). Geneva: World Health

Organization; 2018.

Ministry of Health and Sports Myanmar. Myanmar Demographic and Health Survey 2015-16. Nay Pyi Taw, Myanmar; 2017.

Ministry of National Planning and Economic Development, and Myanmar Ministry of Health. 2011. Myanmar Multiple Indicator Cluster Survey 2009-2010 Final Report: Ministry of National Planning and Economic Development and Ministry of Health. 2011.

Mon AS, Phyu MK, Thinkhamrop W, Thinkhamrop B. Utilization of full postnatal care services among rural Myanmar women and its

determinants: a cross-sectional study. F1000Research. 2018; 7:1-15.

Ministry of Health and Sports Myanmar. Hlaing_Tharyar Township Profile Report Myanmar 2017. Nay Pyi Taw, Myanmar; 2017.

Ministry of Health and Sports Myanmar. Five-Year Strategic Plan for Reproductive Health 2014-2018. Nay Pyi Taw, Myanmar; 2015.

Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice: John Wiley & Sons; 2008.

De Bernis L, Sherratt DR, AbouZahr C, Van Lerberghe W. Skilled attendants for pregnancy, childbirth and postnatal care. British

Medical Bulletin. 2003;67(1):39-57.

Mangeni JN, Mwangi A, Mbugua S, Mukthar VK. Male involvement in maternal healthcare as a determinant of utilization of skilled

birth attendants in kenya. East African Medical Journal. 2012;89(11):372-83.

Chamroonsawasdi K, Soe M, Charupoonphol P, Srisorrachatr S. Rate of Utilization of Skilled Birth Attendant and the Influencing

Factors in an Urban Myanmar Population. Asia-Pacific Journal of Public Health. 2015;27(5):521-30.

Bloom SS, Wypij D, Das Gupta M. Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian city. Demography. 2001;38(1):67-78.

Mekonnen Y, Mekonnen A. Factors influencing the use of maternal healthcare services in Ethiopia. Journal of Health Population and Nutrition. 2003;21(4):374-82.

Khanal V, Brites da Cruz JLN, Mishra SR, Karkee R, Lee AH. Under-utilization of antenatal care services in Timor-Leste: results from Demographic and Health Survey 2009–2010. BMC Pregnancy and Childbirth. 2015;15(1):211.

Win T, Vapattanawong P, Vong-ek P. Three delays related to maternal mortality in Myanmar: a case study from maternal death review,

Choulagai B, Onta S, Subedi N, Mehata S, Bhandari GP, Poudyal A, et al. Barriers to using skilled birth attendants' services in mid- and far-western Nepal: a cross-sectional study. Bmc International Health and Human Rights. 2013;13.

Wilunda C, Quaglio G, Putoto G, Takahashi R, Calia F, Abebe D, et al. Determinants of utilization of antenatal care and skilled birth attendant at delivery in South West Shoa Zone, Ethiopia: a cross-sectional study. Reproductive health. 2015;12(1):1.

World Bank. 2017. An analysis of poverty in Myanmar: part one - trends between 2004/05 and 2015 (Vol. 2) (English).

World Health Organization. Strategies towards ending preventable maternal mortality (EPMM). Geneva: World Health Organization;

Mpembeni RN, Killewo JZ, Leshabari MT, Massawe SN, Jahn A, Mushi D, et al. Use pattern of maternal health services and

determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets. BMC Pregnancy

and Childbirth. 2007;7(1):29.

Duong DV, Binns CW, Lee AH. Utilization of delivery services at the primary health care level in rural Vietnam. Social Science &

Medicine. 2004;59(12):2585-95.

Ministry of Health and Sports Myanmar. Myanmar human resources for health strategy 2018-21. Nay Pyi Taw: Myanmar; 2018

Ministry of Health and Sports Myanmar. Data Dictionary for health services indicators 2018. Nay Pyi Taw; Myanmar; 2018.